Many of us know all too well that low-back pain can be caused by training. The culprit exercises include barbell rows, T-bar rows, squats, deadlifts, seated cable rows, leg raises, Roman-chair situps and seated twists.

The source of the pain can be the disks, facet joints or even a muscle strain, ligamentous sprain or tendinitis. Weakness of the low-back muscles can cause chronic pain. Just because you go to the gym regularly does not guarantee that you have a strong back.

Many cases of low-back pain are caused by weak back muscles that cannot support it during some of the exercises listed above or in simple tasks of everyday life and work. So often health-care providers have emphasized the abdominal muscles. Even today there is so much discussion of “core stability.” The term has become so misused, it’s hard to know precisely what it means. (Similarly, the word holistic has been used to describe so many approaches and methods, we don’t know what it means anymore either.)

I’m not the only one who favors back strengthening over so-called core stability. Back in the 1980s Arthur Jones, the developer of Nautilus machines and an iconic figure in the iron game, felt that many back and neck problems could be alleviated by developing stronger back muscles, not the abdominal muscles. He felt that the only way to spread the idea and make it common knowledge was to insert it into health care.

Jones began the research and developed what he referred to as “medical exercise,” commonly known by the brand name MedX. The development of the back machine focused on isolating the back muscles as much as possible. Jones felt that back exercises too often target the hamstrings and gluteus maximus, leaving the lower back weak. He successfully found a way to isolate the lower-back muscles.

MedX is a system designed to test and strengthen the low-back extensor muscles and the neck extensor muscles. The Lumbar Strength unit offers resistance from five pounds to 400 pounds. The range of motion and resistance are tracked and recorded for each repetition by the computer that operates the unit, one reason that MedX equipment is popular and desired.

Health-care providers in Germany were so impressed with the MedX unit that it became part of the workmen’s compensation system. The reasons for that are threefold: 1) Patients who used MedX had better pain scores, 2) they had better disability questionnaire scores, and 3) they missed fewer days of work. The German government requested that the company manufacture the heavy MedX equipment in Germany to save the shipping fees. Several other countries followed that lead.

Said William Bergman, Ph.D., of the Soft Tissue Center at DISC in Marina del Rey and Newport Beach, California (discmdgroup.com), who has been providing MedX services since 1989, “I have had the privilege of helping more than 10,000 patients achieve function, strength and pain-free spines. My search to find exercises that gave the same results have been fruitless.” MedX providers in other cities can be found at medxonline.com.

Should you or your doctor decide to have you start a MedX program, it will begin with isometric testing to establish your strength and painless range of motion. The following sessions begin the strengthening. Even if you have performed squats or deadlifts with heavy weight, don’t be surprised by the way you feel in the lower-back muscles after the workout. Obviously, untrained people who have back pain need a gentler, slower approach to help guide them out of pain and make them more functional in their daily lives.

One strength coach was having back pain, so she started the MedX. Her back pain stopped, and she found that the mid-pull phase of her power clean had improved, enabling her to increase the weight.

MedX has many purposes and roles, but the bottom line is to improve low-back strength a little or a lot, as the case may need, and to reduce pain.

Train smart; then train hard.

—Joseph M. Horrigan

Editor’s note: Visit www.SoftTissueCenter.com for reprints of Horrigan’s past Sportsmedicine columns that have appeared in IRON MAN. You can order the books, Strength, Conditioning and Injury Prevention for Hockey by Joseph Horrigan, D.C., and E.J. “Doc” Kreis, D.A., and the7-Minute Rotator Cuff Solution by Horrigan and Jerry Robinson from Home Gym Warehouse, (800) 447-0008 or at www.Home-Gym.com.